Psychiatric Comorbidity, Psychosocial Problems, and Functioning of People Who Inject Opioids: An Observational Study

Abstract

Background: Injecting drug use (IDU) is a growing concern in India. This problem may coexist with other psychiatric disorders. The psychiatric comorbidity in IDUrs affects the psychosocial functioning of this population. This study aimed to assess psychiatric comorbidities, psychosocial problems, and global functioning of people who inject opioids. Methods: This cross-sectional study included opioid-dependent individuals with a history of injecting opioids who visited an outpatient clinic for buprenorphine maintenance treatment. The patients were assessed by SCID-I and SCID-II for Axis–I and Axis–II psychiatric disorders, respectively. The diagnosis was confirmed according to DSM-IV-TR. Moreover, the assessment of psychosocial and environmental problems was done according to Axis-IV of DSM-IV. Functioning was assessed using the Global Assessment of Functioning Scale (GAF). Substance use severity was also assessed using Addiction Severity Index (ASI). Findings: A total of 100 participants were included in the study. All participants were male, and the majority (63%) were in the age range of 18-40 years with the mean age of 36.96 (SD=10.12). Moreover, 76% of the participants had psychiatric comorbidity. Mood disorder (28.95%), anxiety disorder (13.16%), any personality disorder (27.63%) were the most common comorbidities. The results also revealed psychosocial and environmental problems were significantly higher in participants with comorbidity and their global functioning was poor. Conclusion: Psychiatric comorbidities are quite common and are associated with various psychosocial and environmental problems. Early identification and interventions for comorbid conditions along with community-based psychosocial rehabilitation should be considered for better outcomes.

Keywords

• opioid-related disorders
• psychosocial functioning
• comorbidity
• heroin dependence